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September 20, 2012

Time For Directors To Realize Cancer Doesn’t Always Lead To Death

by editor

Films that feature characters with cancer have become a familiar sight for movie-goers in recent years, but they rarely portray the patient's chances of survival accurately, Italian researchers will report at the ESMO 2012 Congress of the European Society for Medical Oncology in Vienna, Austria.

After carefully studying 82 movies that center on a person with cancer, from Cat on a Hot Tin Roof, and Gran Torino to Diary of a Country Priest and beyond, Dr Luciano De Fiore from Sapienza University of Rome and colleagues found the cancer experiences described in the films were quite different from the truth.

In recent years, movies have tackled some of the most important issues around cancer, he says, such as epidemiology and environmental causes of cancer in Erin Brockovich, Michael Clayton or The last 56 Hours; the economic implications of therapies in The Rainmaker, the management of symptoms in Wit and Dying Young, and care toward the ending of life in Les Invasions Barbares, Eternity and a Day and The First Beautiful Thing.

"Nowadays cinema is confronting the most important issues for oncological disease, which were mostly absent in the earlier days of cinema," says Dr. De Fiore. "Cancer is no easy matter to portray, and seeing it in a movie gives the audience a chance to give voice to their emotions. This is useful for the sharing of cancer care, from personal or familiar problems to issues of collective relevance."

But things for cancer patients are not always as bleak as movie plots make out, the researchers note. "Very often the ill person doesn't get over the disease and his death is somehow useful to the plot's outcome. This pattern is so strongly standardized that it persists in spite of real progress of treatments."

"Maybe there's an 'educational' gap in the concept of movies on cancer," Dr De Fiore says. "Patients' survival is very rarely due to treatments in the cinema. Fortunately in real life, this has become mostly untrue."

In the movies the researchers studied, 40 characters with cancer were women, and 35 men. In 21 films the type of cancer was not mentioned. Symptoms were considered in 72% of the movies, while diagnostic tests were mentioned in 65%. The most frequent treatment mentioned in the movies was chemotherapy followed by pain-relief. Death occurred 46 times (63% of all movies). Doctors and nurses turned up in 58 films (77%).

Interestingly, Hollywood didn't seem so focused on the big killers among cancer, except for lung tumors, the research showed. "Although breast cancer has a very high impact on female subjects, it is barely represented. Instead relatively rare leukemia, lymphomas and brain tumors predominate."

Despite these flaws, movies about cancer could have a positive impact, for patients and for doctors, say the researchers. "Using the 'big screen' to show stories about cancer could help raise awareness about how large the problem is and what new therapies are available," says Dr De Fiore. "Also, by watching movies on cancer, oncologists could become more conscious of problems they are already facing in the therapeutic setting: cancer and sexuality, the relationship between the patient and the medical staff, side-effects of therapies. And some films simply make us reflect upon the meaning of life and death."

"Theater and movies must always look on 'dramatic' things - this has been true since the days of tuberculosis which was at that time a death sentence and around which a lot of plots evolved, ranging up to such dramatic deaths as in La Boheme or La Traviata," commented Prof Christoph Zielinski, President, Central European Cooperative Oncology Group.

"When considering cancer, the more 'dramatic' forms are being portrayed, as fate of both patients and their surroundings can evolve around them. In reality, it is much more living with cancer, being diagnosed with it, being treated and, finally, surviving it which dominates human lives," Prof Zielinski said.

"The prognoses of the vast majority of these tumors has become much better or at least better over the years. However, the good news is difficult to portray or even to show in drama, which is very nicely shown by this interesting piece of research."